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Quality Project Manager - HEDIS

AIDS Healthcare Foundation Los Angeles, CA
  • Posted: November 16, 2018
  • Full-Time


Does the idea of doing something that really makes a difference in people's lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, AIDS Healthcare Foundation is the place for you!

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF's core values are to be:

Value Employees
Respect for Diversity
Fight for What's Right

STILL INTERESTED? Please continue!

AIDS Healthcare Foundation is seeking a Full-time, Quality Project Manager/HEDIS to assist at our Managed Care Division, California located at the following address:
The Quality Project Manager/HEDIS holds an expertise in the HEDIS/Star Rating Process or similar measurement process providing oversight and direction to insure the best possible results for all the performance excellence and quality initiatives throughout AIDS Healthcare Foundation. The Quality Project Manager works collaboratively with AHF Quality Improvement Staff; validating data against specifications and approving data sets for measurement analytics; particularly HEDIS, Star Measure and satisfaction survey results, report submission and meeting timely and acceptable deliverables to regulatory agencies.
The Quality Project Manager will also work with all staff at AHF health plans, healthcare centers, medical staff, care management staff/nursing and administrative leadership throughout the organization to demonstrate and deploy quality and process improvement efforts that result in achieving superior outcomes. Work will involve multiple initiatives and projects at any given time and will change as the product lines and their related initiatives and projects evolve. The Quality Project Manager is responsible for the timely presentation of education, training and improvement interventions for HEDIS/Star Measurement results to all appropriate committees and schedule needed education and training for measures to all other staff as appropriate.

Under general supervision and/or as part of various workgroups and teams, the Sr. Quality Project Manager performs the following essential functions within the framework of AHF's the core functions and essential services for people living with HIV/AIDS. Other duties may be assigned.

Quality and Performance Improvement
Facilitates and implements the development, tracking, implementation and evaluation of a comprehensive HEDIS/Star measure compliance/communication plan in order to keep department deliverables completed in a methodical and timely fashion.
Presents results of improvement efforts and ongoing performance measures of clinical processes within the organization to senior management and clinical leadership as needed.
Participates in quality improvement projects provided accurate and timely data for the required reports by other staff.
Develops plan for the health education improvement function within the facility in collaboration with the administrative and clinical leaders of the organization for staff, providers, members and others such as vendors, if required.
Provides technical assistance and training on HEDIS, Star Measures, data validation, quality assessment principles, design and methods.

Dimensions of Practice
For the HEDIS/Star Measures Project; leads and directs the work of others. Mentor and develop staff and ensure appropriate, educational programs, orientation and training courses to maintain current and future competency.
Maintains familiarity with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. A wide degree of creativity and latitude is expected.
Participates in the design and application of the individual, organizational and community health improvement strategies with a particular emphasis on developing and implementing evaluation of specific, measurable action plans in partnership with other AHF departments and customers (e.g. Ryan White, Healthy Way L.A).

Analytics and Informatics
Demonstrates subject matter expertise in technical specifications for HEDIS and Star Measures.
Works collaboratively with IT to develop accurate queries for data specifications.
Insures times HEDIS and Star Measures data, reports, analysis and presentations to all appropriate committees and staff.
Validates data and approves data sets for use in line with data specifications from regulatory agencies, NCQA, AAAHC or any other entity required by the organization.
Contributes health informatics expertise to the AHF's community needs assessment process, health improvement goal setting, identification of public health policy and action options, program development, and creation of monitoring and evaluation plans.

Leadership and Systems Thinking
Demonstrates knowledge regarding and compliant with applicable professional practice guidelines and any other Federal and State laws and regulations applicable to practice as a healthcare quality professional.
Supports the National Quality Director by contributing to the creation of a positive work environment that embraces the organizations mission and its process to implement its values.

Policy Development and Program Planning
Serves on AHF committees involved in quality improvement, health education and policy and procedure development related to them.
Makes significant contributions to the development of education, particularly as it relates to HEDIS and Star Ratings and may include other quality improvement initiatives and/or accreditation.

Communication and Cultural Competency
Delivers targeted, culturally-appropriate information to help individuals and groups understand HEDIS/Star Measures and related policies, and regulations.
Utilizes appropriate methods for interacting effectively and professionally with persons of all ages and from diverse cultural, socioeconomic, educational, racial, and ethnic, sexual orientations, lifestyles and physical abilities.
Adheres to ethical principles and AHF in the collection, maintenance, use, and dissemination of data and information.

Financial Planning and Management
May be asked to contribute to the development and preparation of the budget for quality improvement, health promotion and disease prevention initiatives and programs.

Assumes responsibility for own professional growth and development by pursuing education, participating in professional committees and work groups and contributing to a work environment where continuous improvements in practice are pursued.
Participation in AHF Meetings/Committees
Attends Quality Management Committee
Attends AHF meetings as assigned.
Attends community meetings as assigned.
Supervisory Responsibilities
Job may have supervisory responsibilities.

Req No: 2018-8767
External Company URL:
Street: 1001 N. Martel Avenue

AIDS Healthcare Foundation


Los Angeles, CA
90006 USA

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